OpenLB
Open Library of Bioscience
Advanced Search
Kidney medicine
Aug, 2022;4 (8): 100504.

Serum Amyloid A Protein-Associated Kidney Disease: Presentation, Diagnosis, and Management.

Jordan Thorne, David Clark, Laurette Geldenhuys, Keigan More, Amanda Vinson, Karthik Tennankore
Author Information
  1. Jordan Thorne: Department of Medicine, Dalhousie University and Nova Scotia Health.
  2. David Clark: Department of Medicine, Dalhousie University and Nova Scotia Health.
  3. Laurette Geldenhuys: Division of Nephrology, Nova Scotia Health.
  4. Keigan More: Department of Medicine, Dalhousie University and Nova Scotia Health.
  5. Amanda Vinson: Department of Medicine, Dalhousie University and Nova Scotia Health.
  6. Karthik Tennankore: Department of Medicine, Dalhousie University and Nova Scotia Health.
PMID: 35879979 DOI: 10.1016/j.xkme.2022.100504

Abstract

Serum amyloid A protein (AA) amyloidosis, also known as secondary amyloidosis, is a known consequence of chronic inflammation and results from several conditions including inflammatory arthritis, periodic fever syndromes, and chronic infection. AA amyloidosis can lead to multiorgan dysfunction, including changes in glomerular filtration rate and proteinuria. Definitive diagnosis requires tissue biopsy, and management of AA amyloid kidney disease is primarily focused on treating the underlying inflammatory condition to stabilize glomerular filtration rate, reduce proteinuria, and slow potential progression to kidney failure. In this narrative review, we describe the causes, pathophysiology, presentation, and pathologic diagnosis of AA amyloid kidney disease using an illustrative case of biopsy-proven AA amyloid kidney disease in a patient with long-standing rheumatoid arthritis who had a favorable response to interleukin 6 inhibition. We conclude the review with a description of established and more novel therapies for AA amyloidosis including published cases of use of tocilizumab (an interleukin 6 inhibitor) in biopsy-proven AA amyloid kidney disease.

Keywords

AA amyloidosis kidney biopsy nephrotic syndrome rheumatoid arthritis serum amyloid A protein tocilizumab

References

  1. Mod Rheumatol. 2014 Jan;24(1):137-43 [PMID: 24261770]
  2. J Clin Pathol. 2015 Apr;68(4):314-7 [PMID: 25637636]
  3. Lab Invest. 2004 Oct;84(10):1322-38 [PMID: 15286662]
  4. Amyloid. 2011 Dec;18(4):235-9 [PMID: 21992511]
  5. BMC Public Health. 2012 Nov 13;12:974 [PMID: 23148499]
  6. J Intern Med. 2021 Mar;289(3):268-292 [PMID: 32929754]
  7. Br J Haematol. 2001 Sep;114(3):529-38 [PMID: 11552976]
  8. Nephrol Dial Transplant. 2005 Aug;20(8):1721-5 [PMID: 15972323]
  9. Rheumatology (Oxford). 2021 Jul 1;60(7):3235-3242 [PMID: 33291151]
  10. Amyloid. 2015;22(2):84-92 [PMID: 25585627]
  11. Semin Arthritis Rheum. 2015 Dec;45(3):341-50 [PMID: 26228647]
  12. Lancet. 2001 Jul 7;358(9275):24-9 [PMID: 11454373]
  13. Annu Rev Pathol. 2015;10:321-44 [PMID: 25387054]
  14. Ren Fail. 2013;35(4):547-50 [PMID: 23472940]
  15. Front Immunol. 2021 Feb 19;11:631299 [PMID: 33679725]
  16. Rheumatol Int. 2008 Sep;28(11):1155-9 [PMID: 18496698]
  17. Mod Rheumatol. 2019 Mar;29(2):268-274 [PMID: 30132351]
  18. Lab Invest. 1996 Sep;75(3):371-5 [PMID: 8804360]
  19. Acta Haematol. 2020;143(4):312-321 [PMID: 32544917]
  20. Rheumatology (Oxford). 2012 Nov;51(11):2064-9 [PMID: 22879465]
  21. J Rheumatol. 2006 Aug;33(8):1482-7 [PMID: 16881107]
  22. Am J Med. 2006 Apr;119(4):355.e15-24 [PMID: 16564782]
  23. BMC Nephrol. 2017 Dec 29;18(1):377 [PMID: 29287589]
  24. Hum Pathol. 1981 Feb;12(2):160-9 [PMID: 7216218]
  25. Clin Exp Rheumatol. 2015 Nov-Dec;33(6 Suppl 94):S46-53 [PMID: 26120866]
  26. Amyloid. 2013 Dec;20(4):275-6 [PMID: 24106820]
  27. Pathol Int. 2001 Mar;51(3):179-86 [PMID: 11328533]
  28. J Nephrol. 2003 May-Jun;16(3):431-4 [PMID: 12832747]
  29. Case Rep Nephrol. 2014;2014:823093 [PMID: 25197587]
  30. Orphanet J Rare Dis. 2017 May 30;12(1):105 [PMID: 28558744]
  31. PLoS One. 2015 Nov 10;10(11):e0141330 [PMID: 26555695]
  32. Int J Nephrol Renovasc Dis. 2012;5:37-43 [PMID: 22427728]
  33. Nefrologia. 2013;33(3):404-9 [PMID: 23364579]
  34. Arch Intern Med. 2006 Sep 25;166(17):1805-13 [PMID: 17000935]
  35. Clin Epidemiol. 2014 Oct 29;6:369-77 [PMID: 25378951]
  36. Mt Sinai J Med. 2012 Nov-Dec;79(6):749-56 [PMID: 23239212]
  37. Int J Clin Pract. 2021 Jun;75(6):e13966 [PMID: 33368925]
  38. Arthritis Rheum. 2006 Sep;54(9):2997-3000 [PMID: 16947531]
  39. Rom J Morphol Embryol. 2019;60(4):1299-1303 [PMID: 32239108]
  40. Clin Nephrol. 2021 Jan;95(1):54-61 [PMID: 33155543]
  41. Sci Transl Med. 2017 Sep 13;9(407): [PMID: 28904227]
  42. Clin Rheumatol. 2003 Dec;22(6):371-5 [PMID: 14677008]
  43. Arthritis Res Ther. 2017 Oct 17;19(1):231 [PMID: 29041951]
  44. Front Immunol. 2011 Aug 08;2:32 [PMID: 22566822]
  45. Arthritis Rheum. 1994 Dec;37(12):1804-11 [PMID: 7986228]
  46. Clin Kidney J. 2014 Apr;7(2):97-106 [PMID: 25852856]
  47. N Engl J Med. 2007 Jun 7;356(23):2349-60 [PMID: 17554116]
  48. Clin Exp Rheumatol. 2015 Nov-Dec;33(6 Suppl 94):S169 [PMID: 25572486]
  49. CEN Case Rep. 2014 Nov;3(2):237-243 [PMID: 28509209]
  50. Br J Haematol. 2013 May;161(4):525-32 [PMID: 23480608]
  51. N Engl J Med. 2007 Jun 7;356(23):2361-71 [PMID: 17554117]
  52. CEN Case Rep. 2021 Feb;10(1):23-29 [PMID: 32681397]
  53. J Am Soc Nephrol. 2006 Dec;17(12):3458-71 [PMID: 17093068]
  54. Medicine (Baltimore). 2017 Aug;96(34):e7859 [PMID: 28834898]
  55. NDT Plus. 2011 Jun;4(3):178-80 [PMID: 25984151]
  56. Ann Rheum Dis. 2020 Jun;79(6):685-699 [PMID: 31969328]
  57. Br Med Bull. 2013;107:41-56 [PMID: 23896486]
  58. Front Med (Lausanne). 2021 Apr 26;8:661101 [PMID: 33981717]
  59. J Clin Rheumatol. 2013 Jun;19(4):211-3 [PMID: 23669800]
  60. Amyloid. 2020 Mar;27(1):1-12 [PMID: 31766892]
  61. Mod Rheumatol. 2015 Jan;25(1):138-42 [PMID: 24533557]
Journal Article Review
Article has an altmetric score of 10

Word Cloud

Created with Highcharts 10.0.0AAamyloidkidneyamyloidosisdiseaseincludingarthritisSerumproteinknownchronicinflammatoryglomerularfiltrationrateproteinuriadiagnosisbiopsyreviewbiopsy-provenrheumatoidinterleukin6tocilizumabalsosecondaryconsequenceinflammationresultsseveralconditionsperiodicfeversyndromesinfectioncanleadmultiorgandysfunctionchangesDefinitiverequirestissuemanagementprimarilyfocusedtreatingunderlyingconditionstabilizereduceslowpotentialprogressionfailurenarrativedescribecausespathophysiologypresentationpathologicusingillustrativecasepatientlong-standingfavorableresponseinhibitionconcludedescriptionestablishednoveltherapiespublishedcasesuseinhibitorAmyloidProtein-AssociatedKidneyDisease:PresentationDiagnosisManagementnephroticsyndromeserum

Similar Articles

Cited By